The House of Representatives’ failure to adopt a strong amendment preventing the closure of Taunton State Hospital, is a shocking decision that can only be described as an abandonment of responsibility for the care of the mentally ill in Massachusetts.

By Karen Coughlin, RN

The Taunton Daily Gazette, Taunton, MA

By Karen Coughlin, RN

Posted Apr. 30, 2012 at 12:01 AM
Updated Apr 30, 2012 at 6:51 PM

By Karen Coughlin, RN

Posted Apr. 30, 2012 at 12:01 AM
Updated Apr 30, 2012 at 6:51 PM

» Social News

The House of Representatives’ failure to adopt a strong amendment preventing the closure of Taunton State Hospital, is a shocking decision that can only be described as an abandonment of responsibility for the care of the mentally ill in Massachusetts.

We have no mental health care safety net in Massachusetts. There are not, and have not been, enough beds or services in the system for years. This decision will only exacerbate a longstanding crisis, where every emergency department in the state is overcrowded with psychiatric patients waiting for days and even weeks for care. People will continue to go without care, crime will increase, homelessness will increase, more people will end up in the corrections system and many more will commit suicide.

If the closing goes forward, clients and families will be expected to travel 50 to 100 miles for care in Worcester or Tewksbury at facilities that are already over burdened. In addition the closure comes at a time when the state has lost more than 200 mental health inpatient beds, going from 834 beds in 2010 to the current total of 626 beds.

In announcing their decision, the state claims it will move 120 of the 169 beds to the new Worcester State Hospital, with the other 45 beds going to Tewksbury State Hospital. However, the decision to build the new Worcester State Hospital was made to compensate for the closure of Westborough State Hospital a number of years ago. Key Worcester area public officials have voiced opposition to the plan to close Taunton State and have affirmed that the opening of the new facility in Worcester was never intended to provide care to patients served by Taunton State Hospital.

Their plan makes no sense. Our system has been operating well over full capacity for years. We can’t provide the care people need even with our facility open. It’s a travesty.

Our claims are supported by the DMH itself, specifically in a report issued in June of 2011 by a Massachusetts Department of Mental Health Task Force on Staff and Client Safety. The Task Force was convened after the tragic murder of a DMH mental health worker at the hands of a client inappropriately placed in an understaffed group home.

The task force report clearly stated that the system was not serving the needs of the mentally ill. Below is a key section found on page 14 of the report:

“The information we have received from numerous sources is the Commonwealth does not currently have a well-resourced and well-integrated system of services and treatment. This is in part the result of budget cuts that have significantly impacted the availability of services, including hospitalization and related resources.

The lack of resources impacts all levels of care, and deficiencies in any part of the system have ramifications throughout. For example, when DMH intermediate hospitals are filled to capacity (in part because there are insufficient placements in the community for individuals who are ready for discharge) and cannot accept timely transfer of individuals from acute care hospitals; this creates a ‘domino effect.’ The acute care hospital resources then are stretched, making it more difficult for them to admit individuals into their care. This can lead to individuals being ‘boarded’ in emergency department (ED) settings, sometimes for several days.

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Currently, the system is fragmented. It must be strengthened in a way that effectively meets the needs of individuals receiving DMH funded services. A complete, well-resourced continuum of services is the only way to address the safety concerns...

One of the task force’s key recommendations was for the Commonwealth to “increase beds and services across the system as well as work with the complete continuum of care. Safety is compromised because the overall number of community based services/beds, acute hospital beds, and intermediate care beds do not meet the current demands.”

Again, nowhere in their own Task Force report, does the DMH sanction the closure of any bed or service, and in fact, the task force explicitly opposed any effort to compensate for one service by cutting another and emphasizes that a careful study should occur before the elimination of any service stating (on page 6), “Enhancing some services by diminishing others only moves the risks from one place to another.

This has gone beyond an issue of funding and finances. This is a moral and ethical issue of human rights and common decency. We can only hope the Senate will act to preserve this vital strand of the state’s fraying mental health safety net.

Karen Coughlin, RN, is the vice president of the Massachusetts Nurses Association and a nurse at Taunton State Hospital.